Innovations in Urologic Surgical Training
AbstractPurpose of ReviewThis review aims to summarize innovations in urologic surgical training in the past 5 years.Recent FindingsMany assessment tools have been developed to objectively evaluate surgical skills and provide structured feedback to urologic trainees. A variety of simulation modalities (i.e., virtual/augmented reality, dry-lab, animal, and cadaver) have been utilized to facilitate the acquisition of surgical skills outside the high-stakes operating room environment. Three-dimensional printing has been used to create high-fidelity, immersive dry-lab models at a reasonable cost. Non-technical skills such as t...
Source: Current Urology Reports - March 13, 2021 Category: Urology & Nephrology Source Type: research
Primary Renal Synovial Sarcoma and Clinical and Pathological Findings: a Systematic Review
AbstractPurpose of ReviewTo update epidemiological, diagnostic, and therapeutic information on primary synovial sarcoma of the kidney.Recent FindingsA total of 96 studies were analyzed; age at presentation was 38.6 ±14.2 years, predominant location of tumor was right kidney; frequent reported symptoms at diagnosis were hematuria and pain. For definitive diagnosis, cytogenetic technique was used. Detected oncogene was available in 37.8% cases with fusion of SS18-SSX in most patients. Surgery is treatment of ch oice, with adjuvant chemotherapy; most frequently ifosfamide-based associated with doxorubicin or epirubicin. Over...
Source: Current Urology Reports - March 11, 2021 Category: Urology & Nephrology Source Type: research
Precision Stone Surgery: Current Status of Miniaturized Percutaneous Nephrolithotomy
AbstractPurpose of ReviewInnovations in lasers and surgical technology have led to a renewed interest in the miniaturization of percutaneous nephrolithotomy (PCNL). We review the different approaches and evidence on the efficacy of mini-PCNL.Recent FindingsMini-PCNL encompasses a range of techniques using tract sizes from 4.8 to 22 F to treat renal stones. The most common device uses irrigation to passively extract stones out of the sheath. Super-mini-PCNL incorporates active suction. Ultra- and micro-techniques reduce the tract to smaller diameters. Laser fragmentation is the main lithotripsy modality. Studies demonstrate...
Source: Current Urology Reports - February 12, 2021 Category: Urology & Nephrology Source Type: research
Current Trends in Management of Renal Cell Carcinoma with Venous Thrombus Extension
AbstractPurpose of ReviewTo review the evidence regarding the current trends in surgical management of renal cell carcinoma (RCC) with inferior vena cava (IVC) thrombosis. Recent published series have shown the role of minimally invasive surgery in IVC thrombectomy. This review article evaluates the present RCC with venous extent literature to assess the role of open and minimally invasive surgery in this scenario.Recent FindingsRobotic urological surgery has shown to have known benefits in radical prostatectomy, partial nephrectomy, and pyeloplasty. Recent published series showed feasibility of robotic IVC thrombectomy ev...
Source: Current Urology Reports - February 8, 2021 Category: Urology & Nephrology Source Type: research
Single Port Robotic Surgery in Urology
AbstractPurposeTo provide a comprehensive review on the new da Vinci SP (single port) robotic surgical system. The published literature to date within urology and a description of the new system will be discussed.FindingsThere are currently no high-quality published studies with the SP robotic system. All studies are case series, many with 10 or fewer patients. However, all studies have found the SP system to be safe and feasible in performing most urological procedures.SummaryRenal and pelvic surgery using the SP robotic system is safe and feasible in the hands of expert robotic surgeons. Long-term, high-quality data is l...
Source: Current Urology Reports - February 8, 2021 Category: Urology & Nephrology Source Type: research
Marijuana, Alcohol, and ED: Correlations with LUTS/BPH
AbstractPurpose of ReviewBenign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) is a disease complex with enormous societal burden and yet the pathogenesis of LUTS/BPH is poorly understood. We set out to review the literature on the relationship between depression, marijuana usage, and erectile dysfunction (ED) to LUTS/BPH.Recent FindingsLUTS/BPH has independent associations with depression as well as with ED. In each case, the causality and mechanistic relationship is unknown. The impact of marijuana, as it increasingly pervades the general population, on the disease complex of LUTS/BPH is not well stu...
Source: Current Urology Reports - February 8, 2021 Category: Urology & Nephrology Source Type: research
Erectile and Ejaculatory Dysfunction After Urethroplasty
AbstractPurpose of the ReviewThe goal of this paper was to evaluate the impact on erectile and ejaculatory function after anterior and posterior urethroplasty.Recent FindingsWith a rise in the use of urethroplasty, its impact on sexual function has come into question. For anterior urethroplasties, some degree of erectile dysfunction is common, but this tends to be transient, with most patients having a resolution of any de novo dysfunction by 12 months. Patients with posterior urethral strictures have a very high rate of erectile dysfunction prior to surgery and may show improvement after urethroplasty. Ejaculatory functio...
Source: Current Urology Reports - February 8, 2021 Category: Urology & Nephrology Source Type: research
State of the Reservoir: Current Concepts of Penile Implant Reservoir Placement and Potential Complications
AbstractPurpose of ReviewTo discuss mechanical and surgical innovations in inflatable penile prosthesis (IPP) surgery and their implications on reservoir placement and patient outcomes.Recent FindingsThe past decade has seen a new emphasis on optimizing outcomes and minimizing complications associated with IPP reservoirs. Innovations in device design have accordingly yielded safer, more durable IPP outcomes over the past four decades. Modifications in surgical approach for reservoir placement abound for both traditional space of Retzius and ectopic reservoir placement techniques.SummarySurgical and medical history, patient...
Source: Current Urology Reports - February 8, 2021 Category: Urology & Nephrology Source Type: research
Self-Induced Trauma to the Genitalia: a Review of the Literature and Management Schemes
AbstractPurpose of ReviewSelf-induced genital trauma is rare, and prompt and evidence-based early intervention can improve the urinary and sexual function of these complex patients. This review has surveyed current literature and treatment trends to evaluate the clinical approach to managing genital trauma.Recent FindingsA literature review was performed regarding self-induced genitalia trauma and trauma management between 2000 and 2019 using MEDLINE ® database, the Cochrane Library® Central Search, Web of Science, and Google Scholar. In total, 42 articles were considered relevant and included in this review.SummarySelf-...
Source: Current Urology Reports - February 3, 2021 Category: Urology & Nephrology Source Type: research
Pain Management Strategies in Contemporary Penile Implant Recipients
AbstractPurpose of ReviewTo review the most recent literature citing opioid-sparing multimodal analgesic strategies used to manage perioperative pain in patients who underwent inflatable penile prosthesis (IPP) surgery and to provide the penile implant surgeon a variety of non-opioid-based pain management strategies for IPP management.Recent FindingsInterventions performed in the pre-operative, intraoperative, and post-operative arenas have all been shown to effectively lower pain scores and reduce opioid consumption. Certain surgical techniques performed during IPP surgery have helped with post-operative discomfort patien...
Source: Current Urology Reports - February 3, 2021 Category: Urology & Nephrology Source Type: research
Management of the Transitional Urology Patient: the Role of the Adult Reconstructive Urologist
AbstractPurpose of ReviewPatients with congenital urologic conditions present unique challenges as adults. Herein, we review the literature relevant to the adult reconstructive urologist confronted with complex surgical concerns affecting their patients with a history of hypospadias, spina bifida, and other syndromes affecting the genitourinary tract.Recent FindingsUrethral stricture disease related to hypospadias is complex, but successful urethroplasty and penile curvature correction can be achieved with an anatomically minded approach. Multiple urinary diversion techniques can be considered in a patient-centered approac...
Source: Current Urology Reports - February 3, 2021 Category: Urology & Nephrology Source Type: research
A Review on Penile Length and Girth Issues in Penile Prosthetic Surgery
AbstractPurpose of ReviewThe goal of this paper is to understand the reasons behind penile length and girth issues after penile prosthesis surgery and review the literature for current strategies employed to decrease these issues.Recent FindingsMeasurement inconsistencies triggering further studies have shown there is a real loss of penile length and girth after prosthesis surgery. There have been varying hypotheses of why this happens, and numerous approaches have been proposed to help combat this in the preoperative, intraoperative, and postoperative settings.SummaryErectile dysfunction prevalence is expected to increase...
Source: Current Urology Reports - February 3, 2021 Category: Urology & Nephrology Source Type: research
Imaging in Gender Affirmation Surgery
AbstractPurpose of ReviewThis review summarizes recent developments in gender affirmation surgery, imaging findings in patients undergoing these surgeries, focusing on common postoperative radiologic appearances, complications, and pitfalls in interpretation.Recent FindingsThe imaging workup of masculinizing and feminizing genitourinary surgeries uses multiple modalities in presurgical planning and within the immediate and long-term postoperative period. CT and MRI can help identify immediate and remote postoperative complications. Fluoroscopic examinations can diagnose postoperative urethral complications after gender aff...
Source: Current Urology Reports - January 30, 2021 Category: Urology & Nephrology Source Type: research
The Management of Penile Fracture: a Review of the Literature with Special Consideration for Patients Undergoing Collagenase Clostridium Histolyticum Injection Therapy
AbstractPurpose of ReviewTo review the current literature on acute management of traumatic penile fracture, with a specific discussion of those injuries following collagenase clostridium histolyticum (CCH) injections for the treatment of Peyronie ’s disease.Recent FindingsThe immediate repair of traumatic penile fracture injury is associated with significantly better prognosis for long-term sexual health. Corporal disruption following CCH administration has several distinct features, and the trend is to manage these patients conservatively in the absence of urethral injury.SummaryTraumatic penile fracture repair continue...
Source: Current Urology Reports - January 20, 2021 Category: Urology & Nephrology Source Type: research
Chronic Scrotal Content Pain: a Review of the Literature and Management Schemes
AbstractPurpose of ReviewChronic scrotal content pain (CSCP) is a complex condition with multiple etiologies that requires a thorough understanding of its pathophysiology, workup, and treatment options. We performed a comprehensive and contemporary review to augment our current understanding of CSCP.Recent FindingsWe discuss new advances in CSCP-specific pain questionnaires, modern studies of microscopic spermatic cord denervation and its variations, and novel techniques including electric nerve stimulation and cryoablation in addition to randomized control trials with significant negative findings. We also present literat...
Source: Current Urology Reports - January 15, 2021 Category: Urology & Nephrology Source Type: research
